Care providers reluctant to explain *undetectable equals untransmittable* to patients

From Medscape

WASHINGTON, DC — HIV treatment that leads to viral suppression for at least 6 months is 100% effective in preventing the transmission of HIV, even in the absence of condoms or HIV prevention drugs, according to the Centers for Disease Control and Prevention. But not all care providers tell their patients that.

A survey in the Midwest showed that 22% of HIV physicians still don’t feel comfortable explaining to patients the science behind what is known in the community as U=U, or undetectable equals untransmittable.

And that number is even higher among the physician assistants, nurse practitioners, advanced practice nurses, and traditional registered nurses who serve people living with HIV, said Emily Petran, MPH, from the Minnesota site of the Midwest AIDS Training and Education Center (MATEC) in Minneapolis.

The survey — which was more of a needs assessment than a scientific survey — points to the need for education so that people with HIV have all the information they need to care for themselves and their partners, she said here at the United States Conference on AIDS 2019.

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Learning he was “undetectable” was a game changer

In 2012, Bruce Richman received news about his health that would set him on an unexpected path.

His doctor explained to him that he was “undetectable,” meaning that by adhering to his HIV antiretroviral therapy, the viral load in his blood was so low that it could no longer be detected.

Bruce Richman, founder of Prevention Access Campaign, is working to change the way the world views people living with HIV

This was a game changer for him. The news meant that Richman, who first found out he had HIV in 2003, would be unable to pass the virus on to any sexual partner.

“I found out nine years after my diagnosis that I can’t transmit the disease. My doctor told me and, here I am, a privileged white guy with a support system. I’m privileged with this information, and I started looking around and saw that nothing confirmed it was true,” Richman told Healthline. “I started doing research. There was no information out there to the general public that was clear and inclusive and accepted that this was true.”

Richman’s realization that this information, which could benefit thousands upon thousands of people living with HIV, rested mainly within medical circles — accessible to those with connections and privilege — awakened something within him.

Continue reading on Healthline.com.

Overwhelming evidence shows HIV undetectable = untransmittable

From Gay Star News

HIV positive people with an undetectable viral load cannot sexually transmit HIV. That’s the unequivocal conclusion from one of the leading health agencies in the US.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of recent research. Their conclusion is simple: Undetectable = Untransmittable (U=U). It’s the same message now backed by over 300 health agencies all around the world.

The results of the NIAID review were published yesterday in the Journal of the American Medical Association (JAMA). One of the reports co-authors is NIAID Director, Dr Anthony Fauci. He is widely regarded as one of the world’s leading HIV experts.

In a statement, NIAID called evidence for Undetectable = Untransmittable ‘overwhelming’. Not only does getting those diagnosed with HIV on to Antiretroviral Therapy (ART) ensure their long term health. But it also significantly reduces HIV transmission rates. This is because those with the virus suppressed in their body cannot pass it on.

The authors pointed to research that looked at over 77,000 examples of condomless sex between serodiscordant male couples. One half of the couple had HIV and the other did not. There was not a single transmission of the virus from the HIV positive person to the negative person.

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Gay Men Still Don’t Believe Undetectable = Untransmittable

From Logo online

Last September, on National Gay Men’s HIV/AIDS Awareness Day, the Center for Disease Control (CDC) declared that men with HIV who have an undetectable viral load—levels of HIV in the blood that are below the threshold of detection—are unable to transmit HIV to their partners. This is often summarized with the phrase Undetectable = Untransmittable or U = U.

The CDC came to this conclusion after evaluating three studies that included thousands of couples engaging in unprotected sexual acts in which one partner was HIV-positive with an undetectable viral load, and the other was HIV-negative and not on pre-exposure prophylaxis (PrEP).

“No HIV transmissions to an HIV-negative partner were observed when the HIV-positive person was virally suppressed,” the CDC reported.

When levels are this low, the virus is so suppressed that it’s impossible to pass on the virus to a partner sexually. Consequently, HIV treatment is now being used as a form of prevention, commonly referred to a TasP (Treatment as Prevention).

It’s been over 30 years since the inception of the virus, and still, there is so much shaming and stigma surrounding people living with HIV. This in large part due to misinformation and fear of contracting the virus. That’s what led Drs. Jonathon Rendina and Jeffrey Parsons of Hunter College to explore whether gay, bisexual, and other men who have sex with men actually believe that undetectable = untransmittable.

After the AIDS epidemic there was “a sense that nobody could be trusted that had negative effects on guys with and without HIV,” Dr. Rendina tells Newnownext.

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Undetectable viral load “completely effective” at stopping HIV transmission, study finds

From Buzzfeed

A groundbreaking new study found zero transmissions occurred between HIV-positive men with an “undetectable viral load” due to treatment, and their HIV-negative partners, across thousands of instances of anal sex without a condom.

The Opposites Attract study, led by professor Andrew Grulich from the Kirby Institute, followed a cohort of 358 gay male couples – one partner HIV-positive, the other HIV-negative – in Australia, Thailand and Brazil.

The HIV-positive partners in the study had an “undetectable viral load”, meaning they are on treatment to suppress the virus so it is undetectable in the blood.

Not a single HIV transmission occurred across the almost 17,000 times participants reported having anal sex without a condom.

12,000 of those sexual encounters were protected solely by the HIV-positive partner’s undetectable viral load, and in the other 5,000, the HIV-negative partner was also taking a drug to protect against contracting HIV, known as PrEP.

“It really does confirm that undetectable viral load is completely effective at preventing transmissions in gay couples,” Grulich told BuzzFeed News from Paris, where he is presenting the research to the International Aids Society (IAS) Conference on HIV Science.

“Essentially, we’re documenting that this is a form of safe sex for couples in this situation.”

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